PAPAVERACEAE

Annual or perennial herbs with watery sap or milky or coloured latex.

There are 26 genera world-wide and about 200 species, mostly from the temperate Northern Hemisphere. Some plants of the family contain narcotic and medicinal alkaloids.

Chelidonium majus

Greater celandine

Description

A perennial herb with a branched, woody orange-coloured rootstock, releasing orange latex when broken. Stems erect, slender, sparsely hairy at nodes, brittle, 30–90 cm tall in flower. Leaves pinnate, lamina 5–15 × 5–12 cm. Lateral leaflets in 3–5 pairs, ovate to elliptic, bicrenately lobed. Midrib and petioles narrowly winged, and wing expanded at the base of the petiole. Terminal leaflet ternate. Stems and leaves also contain orange latex. Foliage often blue-green. Peduncles 2–10 cm long with 2–6-flowered umbels. Sepals obovate, 8 × 5 mm. Petals yellow, obovate and up to 1 cm long. Capsule linear, somewhat constricted between seeds, 20–50 mm long. Plant flowers and fruits in spring and summer.

images

Family Papaveraceae

Odour—peculiar and unpleasant; taste—bitter and pungent.

Habitat and cultivation

Native to temperate Europe and Britain and naturalised elsewhere. Grows easily from seed in light soils in sun or semi-shade. Drought and frost resistant.

Parts used

Fresh or dried herb gathered at, or just prior to, flowering. The fresh latex.

Active constituents

1) Alkaloids (0.6–1.75%)—at least 20 have been identified.1,2 They are of the isoquinoline type mainly coptisine3 also chelidonine, homochelidonine, berberine, protopine, stylopine and smaller amounts of chelerythrine and sanguinarine.1,4,5 (These latter alkaloids are found in higher concentration in the root of the herb.6) The content of alkaloids is dependent on temperature and light conditions7 and stage of development of the plant8

2) Flavonoids

3) Phenolic acids including those derived from caffeic, p-coumaric and ferulic acids9

Also contains proteins10 (content varies with time of year11) but includes enzymes—oxidases,11,12 proteolytic enzymes and nucleases11,13—lectins13 and a proteinase inhibitor (chelidocystatin),14 a bitter principle—chelidoxanthin, volatile oil and the plant acids chelidonic, succinic, citric and malic acids.

Nutritional constituents

Vitamins: Nicotinic acid

Minerals: Calcium, potassium, magnesium, phosphorus, sulphur and some iron1

Actions

1) Spasmolytic

2) Cholagogue

3) Diuretic

Scientific information

Chelidonium has been used medicinally at least since the middle ages. It has been an official medicine in both western and eastern traditions. There are a number of biologically active components, including the alkaloids. The proteins in the latex are also considered likely to be pharmacologically active.11 Constituent levels vary according to plant maturation, possibly altering the herb's observed actions.8

Antimicrobial

In vitro—The herb and/or its constituents have the following activities:-

The peroxidase and nucleases, which protect the plant from pathogens, have general antimicrobial activity.11

In vivo—Clinical trials with toothpaste containing sanguinarine reduced plaque and gum disease.21,22 Both sanguinarine and chelerythrine may reduce halitosis by reducing the oral production of volatile sulphur compounds.23

Celandine was used to treat chronic tonsillitis in children improving their immune function, including their non-specific resistance, and decreasing disease recurrence.24

Anticancer

In vitro—The anticancer properties of some of the alkaloids particularly sanguinarine, chelerythrine and chelidonine have been noted.25–28 Sanguinarine and berberine can interact with DNA which may contribute to their cytotoxicity.6 The alkaloids are toxic to cancer cells29 whilst the whole extract is cytostatic.30

A chemotherapeutic agent has been produced based on the modified alkaloids of Chelidonium. Called Ukrain it has been subject to fairly extensive testing in vitro and in vivo, the results of which have been reviewed and are considered promising.31 The actions of Ukrain cannot be extrapolated to Chelidonium itself.26

In vivo—As part of a Chinese preparation it had an antitumour effect in patients with oesophageal cancer.32

Other

In vitro—Chelidonium and some of its alkaloids inhibit acetylycholinesterase,33,34 the herb also modulates binding to GABAA receptor sites.35

Anti-inflammatory activity has been demonstrated in whole extracts36,37 as well as by alkaloids, in particular sanguinarine38 (also inhibits platelet aggregation,39 COX-139 and 5-LOX37).

The extract is anti-oxidant36 (although this action may not be very strong40) and it is capable, ex vivo, of stimulating an immune response in blood samples from patients with infections who had low immune function.41

In vivo—A preparation containing Curcuma longa (turmeric) and Chelidonium gave symptomatic relief of right upper abdominal colic attributed to biliary dyskinesia.42

Apart from those using Ukrain there are no other modern clinical trials.

Medicinal uses

Respiratory tract

Gastro-intestinal tract

Weiss claims that Chelidonium, if not used within 6 months, loses efficacy giving inconsistent results. However the spasmolytic action and the cholagogue effect (which he says has been shown to increase pancreatic enzyme secretion) aid:

Externally

The fresh latex from the broken stem is applied directly to the skin where it may inactivate wart viruses:

Pharmacy

Three times daily  
Infusion of dried herb –   2–4 g
Tincture 1:10 (45%) –   2–4 ml
Fluid Extract (25%) –   1–2 ml

Precautions and/or safety

In vitro—Studies using tinctures with up to 6.2 mg/g of total alkaloids were not toxic to hepatocytes,43 and in standard bioassays.2

In vivo—Recorded minor side-effects include a dry mouth and dizziness.

There are a number of cases in the literature linking the use of Chelidonium to reversible hepatitis albeit in a relatively small number of cases (10 people over 3 years).44 The hepatitis may be due to an idiosyncratic reaction44–46 or possibly a herb-induced auto-immunity.47 These cases were mainly in Germany and occurred after either using extracts standardised on chelidonine or preparations of which Chelidonium was a part.48 As preparations containing Chelidonium have been very widely used in Germany under the assumption the herb is safe, it is suggested the number of untoward events may be under recorded.45 One unusual case of Chelidonium causing haemolytic anaemia49 and one of contact dermatitis to the latex have also been reported.50

Historical uses

Blood cleanser; diaphoretic (hot infusion). Torpid liver conditions. Cure for sore eyes and films in the eyes. Also used for dropsy; itch; scurvy; ringworm; corns; tetters; old sores and ulcers. The juice taken, with fasting, for the pestilence; rubbed on the abdomen for griping and post-partum pains. Applied to the breasts to reduce heavy menstruation. Toothache (gargle); haemorrhoids (ointment). In Traditional Chinese Medicine it is used as a pain-killer, antitussive, alterative and anti-inflammatory.

Eschscholzia californica

Californian poppy

images

Family Papavaraceae

Description

A fast-growing, slender, erect annual or perennial with much dissected blue green leaves growing to 60 cm. Stems branched, and glabrous. Flowers solitary, showy yellow or orange-red. Sepals 2, forming a hood-like cap, pushed off upwards by the 4 petals as they open. Capsules slender to 10 cm long. Sap colourless. Flowers throughout summer.

Habitat and cultivation

Native to western North America. Always grown from seed and self-sows freely in suitable situations. Prefers full sun and well-drained soil.

Parts used

The herb gathered during flowering.

Active constituents

1) Alkaloids—isoquinoline type including californidine, californine (escholtzine), protopine, allocryptopine, lauroscholtzine (N-methyllaurotetanine) also sanguinarine, chelerythrine, laurotetaine and caryachine derivatives51–53

2) Flavonoids including those based on rutin, quercetin and isorhamnetin54

Actions

1) Sedative

2) Anxiolytic

3) Analgesic

Scientific information

Research into this herb is occurring at present, being driven by the interest in the alkaloids which are related to those in Papaver somniferum—opium poppy—and also because of their particularly antimicrobial and anticancer potential (sanguinarine, chelerythrine and protopine).51,55–57 Protopine also has anti-inflammatory58 and nematocidal59 properties in vitro.

The western use of the herb, adopted from the Native Americans’ understanding, is for its actions on the nervous system, an action due predominantly to the alkaloids.

In vitro—The alkaloids may act via benzodiazepine receptors and/or via inhibition of the degradation of catecholamines. They also interact in vitro with serotonin receptors.52

In vivo—The herb either by ingestion or smoking can supposedly create a state of mild euphoria lasting 20–30 minutes.53 A clinical trial using a medicine, registered in France, which combines Cratageus and magnesium with Eschscholzia was beneficial in the treatment of mild to moderate anxiety.60

Weiss says of the herb its action is gentle and an aid to “establishing equilibrium and it is not narcotic”.

Medicinal uses

Urinary tract

Weiss recommends its use as an aid to treating:

Nervous system

The main use of Eschscholzia is to treat:-

Pharmacy

There are no current guidelines on dosage for this herb. Weiss recommends one teaspoonful per cup of dried herb as an infusion. He considered the herb to be safe and suitable for use in children.

The formulated medicine in the above clinical trial used two tablets twice daily and contained 20 mg of an aqueous extract of Eschscholzia.60

King's Dispensatory recommends a dose of between 12–185 grains which converts to 0.8–12 g of herb, as a single dose.

In animal studies doses between 25–200 mg per kg were used, the lower doses being considered anxiolytic and the larger ones sedative.61 This equates to 1.5–6 gm for a 60 kg adult if the action were to be the same in humans.

Three times daily (suggestion based on Chelidonium with similar alkaloids)

Infusion of dried herb –   2–4 g
Tincture 1:10 (45%) –   2–4 ml
Fluid extract (25%) –   1–2 ml

Interactions

In vitro—Some of the alkaloids inhibit CYP3A452 although no interactions of the herb with drugs metabolized by this enzyme have yet been reported.

Historical uses

An analgesic used in toothache. To stop lactation by topical application of the crushed seeds. Children's sedative. As a compress for healing wounds.

Sanguinaria canadensis

Blood root

images

Family Papavaraceae

Description

Perennial, 15–30 cm tall. Rhizome horizontal, extending 5–10 cm, cylindrical, slightly branched with numerous tender rootlets underneath, brownish red externally and exuding a blood-red juice when cut. Previous year's shoots leave scars on the rhizome. Stems simple, smooth naked scapes each topped by a single flower which appears before or with the leaves in early spring. Leaves palmately seven-nine lobed, upper surface light green, underside whitish, glaucous. Ribs prominent. Flowers—sepals two, forming an ephemeral calyx. Petals 8–12, white, to 5 cm in diameter, spatulate, not crumpled. Stamens usually 24, unequal, arranged more or less distinctly in 2 rows. Pollen golden yellow. Style, short, thick, rounded. Pod oblong, sharp-pointed, turgid, opening by 2 uplifting valves to allow the escape of numerous seeds. Seeds poisonous. Flowers in spring.

Odour—slight; taste—acrid, bitter and nauseating.

Habitat and cultivation

Native to rich, open woods of North America from Manitoba and Nova Scotia to Florida and east Texas. Grows in a moist, shady places under deciduous trees. Cultivated in similar places elsewhere. Propagated by root division in autumn. Frost resistant, drought tender.

Parts used

Rhizome, gathered in autumn. The rhizome is ready for harvesting about 6 years after growing from seeds or 4–5 years from cuttings. Wildcrafting may lead to this herb becoming endangered.

Active constituents

1) Isoquinoline alkaloids including mainly sanguinarine (up to 4%) and chelerythrine (up to 2%), also chelirubine, sanguirubine, sanguilutine, protopine and allocryptopine.62–65 Oxysanguinarine is produced when sanguinarine is exposed to light. Levels of sanguinarine are highest in plants harvested at higher altitudes, in early spring just after flowering63

2) Red resin

Also chelidonic, malic and citric acids, gum, starch and sugars.66

Actions

1) Expectorant

2) Spasmolytic

3) Emetic

4) Cardioactive

5) Cathartic

6) Antiseptic Topically

7) Irritant

8) Escharotic

Scientific information

The name of this plant, Sanguinaria, derives from the red blood-like latex that oozes when rhizomes are cut. It was an official medicine in the American Pharmacopoeia until 1926.

In the 1980's the root extract was used in toothpastes because of its anti-plaque properties but it fell out of favour when possible links to an increased cancer risk were reported. It is again receiving interest for use in animal feeds, as a natural antibiotic, and because it increases the weight of livestock. There are moves to encourage the cultivation of Sanguinaria in the United States.63 Whilst the alkaloid content of wildcrafted rhizomes is higher than that of cultivated plants they are also more variable.63

Antimicrobial

In vitro—An extract and/or the main alkaloids have good antimicrobial activity against a range of strains of Helicobacter pylori,67 some species of Mycobacterium including M. tuberculosis (traditional use of herb)68 and a range of Gram-positive and Gram-negative plaque bacteria69 in which sanguinarine seems to specifically accumulate and be retained.70

In vivo—A number of clinical studies have been conducted using an extract in mouth rinses and toothpastes. Many have shown these preparations reduced plaque and gingivitis safely,71–78 although not all trials were in agreement as to its efficacy.79–82 It was used in commercial products for this purpose until it was apparently linked to an increased incidence of leukoplakia, a precancerous condition.83–85 Reviews of data by an expert panel concluded that Sanguinaria, at normal concentrations was, and is, in fact safe and effective and not causally related to leukoplakia development.86–88 Design flaws in research methodology may have contributed to the conflicting results obtained.89

Anticancer

In vitro—Sanguinarine inhibits the proliferation of various types of cancer cells—epidermal,90 prostate (whether androgen-dependent or not),91 keratinocytes,92 cervix93 and lymphoma.94 It was also effective against some cancer cells resistant to current chemotherapeutic agents.93,94 The alkaloid inhibits DNA transcription,95 selectively causes apoptosis and necrosis of cancer but not normal cells,96 and may inhibit angiogenesis an important stage in the progression of cancer.97

In vivo—A paste containing Sanguinaria with zinc chloride and antimony sulphide has been marketed for the treatment of skin cancers including melanoma. The safety and efficacy of such preparations has been called into question because of poor outcomes in anecdotal cases.98,99 A similar preparation (called Mohs paste) had been in use, as an injection in the 1930's, in the orthodox treatment of tumours but has since been superceded.100

Other

Sanguinarine is anti-oxidant,101 anti-inflammatory102 and has antiplatelet activities.102 The alkaloids would seem to be responsible for most of the observed actions of the herb.

Medicinal uses

Cardiovascular system

Used for improving:

Respiratory tract

It is expectorant in small doses and also seems to relax bronchial muscles:

BHP specific indication—asthma and bronchitis with feeble peripheral circulation.

Gastro-intestinal tract

Externally

More recently external preparations have included Sanguinaria to treat:

As a snuff for:

Pharmacy

Three times daily  
Dried rhizome –   0.06–0.5 g
Tincture 1:5 (60%) –   0.3–2 ml
Fluid extract (60%) –   0.06–0.3 ml

As snuff a pin-head size quantity of powdered rhizome is all that should be used for a single dose.

Single dose for emesis

Dried rhizome –   1–2 g
Tincture –   2–8 ml
Fluid extract –   1–2 ml

Sanguinaria was used in anti-plaque toothpastes at concentrations of 0.075% and in mouthwashes at 0.03%. It is no longer used in dentifrices.

Precautions and/or safety

In vitro hepatocyte cytochrome P450 isozymes reduce the potential toxicity of sanguinarine103 which at high enough doses is toxic (the same is true for chelerythrine). The alkaloids are not believed to be toxic in vivo104 however recommended doses of the herb should not be exceeded.

In excess it may cause intense thirst, vomiting, faintness, vertigo, burning in the stomach, prostration and dimness of vision.

Historical uses

For fevers; atonic dyspepsia; dysentery; torpid liver; tuberculosis; scrofula; heart disease and palpitations. Used externally for fungal infections including ringworm; eczema especially when associated with varicose ulcers; cancers; skin growths.